ETINS 
EDUCATION 


OF 
HARVARD  UNIVERSIT 


NUMBER  VII 


NOVEMBER,  1920 


SIGHT- SAVING  CLASSES  IN  THE 
PUBLIC  SCHOOLS 


BY 

R.  B.  IRWIN 

SUPERVISOR,  DEPARTMENT  FOR  THE  Bl 
CLEVELAND  PUBLIC  SCHOOLS 


'UBLISHED  BY  HARVARD  UNIVERSITY 
CAMBRIDGE,  MASS. 


HARVARD  BULLETINS  IN 
EDUCATION 

NUMBER  VII 


HARVARD  BULLETINS  IN  EDUCATION 

I.  THE  SCHOOL  SYSTEM  AS  AN  EDUCATIONAL  LAB- 
ORATORY.  By  Win.  S.  Learned.    25  cents. 

II.  SCALES  FOR  THE  MEASUREMENT  OF  ENGLISH  COM- 
POSITION. By  Frank  W.  Ballou.  50  cents. 

III.  BRIDGING  THE  GAP:  THE  TRANSFER  CLASS.   By 
F.  W.  Wright.    30  cents. 

IV.  A  SELECTED  CRITICAL  BIBLIOGRAPHY  OF  VOCA- 
TIONAL GUIDANCE.    By  John  M.  Brewer  and  Roy 
W.  Kelly.    50  cents. 

V.  A  DESCRIPTIVE  BIBLIOGRAPHY  OF  MEASUREMENT 
IN  ELEMENTARY  SUBJECTS.  By  Henry  W.  Holmes 
and  others.  50  cents. 

VI.   BUSINESS  PRACTICE   IN   ELEMENTARY  SCHOOLS. 
By  Roy  Davis.    50  cents. 


HARVARD  BULLETINS  IN  EDUCATION 

SIGHT-SAVING  CLASSES  IN 
THE  PUBLIC  SCHOOLS 

BY 
R.  B.  IRWIN 

SUPERVISOR,  DEPARTMENT  FOR  THE   BLIND 
CLEVELAND  PUBLIC  SCHOOLS 


This  Bulletin  is  issued  under  the  auspices  of  the 
Schools  Committee  of  the  Associated  Harvard  Clubs 


PUBLISHED  BY  HARVARD  UNIVERSITY 
CAMBRIDGE,  MASS. 


COPYRIGHT,  1920 
HARVARD  UNIVERSITY 

First  impression,  November,  1920 
Second  impression,  June,  1921 


FOREWORD 

THE  publication  of  this  Bulletin  is  made  possible  through  the  gen- 
erous support  of  Mr.  Murray  Seasongood,  'oo,  of  Cincinnati, 
Chairman  of  the  Schools  Committee  of  the  Associated  Harvard 
Clubs. 

Readers  of  this  monograph  will  be  interested  to  know  that  the 
author,  Mr.  R.  B.  Irwin,  himself  blind,  is  to  be  one  of  the  lecturers 
in  an  extension  course  on  the  Education  of  the  Blind,  undertaken 
in  1920  by  the  Graduate  School  of  Education,  Harvard  Univer- 
sity, with  the  cooperation  of  the  Massachusetts  Department  of 
Education,  Division  of  the  Blind,  the  Perkins  Institution  for  the 
Blind,  and  the  Association  for  the  Promotion  of  the  Interests  of 
the  Adult  Blind.  Inquiry  concerning  this  course  may  be  ad- 
dressed to  the  Graduate  School  of  Education,  Lawrence  Hall, 
Cambridge,  Massachusetts. 


459126 


INTRODUCTION 

LIKE  a  shaft  of  sun  penetrating  their  twilight  has  come  the  Sight 
Saving  Class  to  our  visually  handicapped  school  children. 

Parents,  educators,  in  fact  the  general  public  look  upon  all 
children  who  are  not  definitely  blind  as  having  normal  eyesight. 
Only  the  few  who  have  had  the  fact  forcibly  brought  to  their  at- 
tention realize  the  existence  of  a  third  group  —  the  children 
whose  light  is  darkened.  So,  little  ones  whose  eyesight  is  reduced 
to  one-third,  one-quarter,  or  even  a  tenth  of  normal  are  required 
with  the  same  equipment  to  meet  the  standards  reasonably  de- 
manded of  the  unhandicapped  child. 

The  Sight  Saving  Class  seems  the  reasonable  solution  for  these 
most  unfortunate  of  children.  Probably  no  one  knows  this  sub- 
ject better  than  Mr.  Irwin  who  has  been  associated  with  the  work 
practically  since  its  beginning  and  has  also  known  schools  for  the 
blind  since  his  early  childhood.  He  tells  us  concisely  the  causes  of 
visual  disability  in  school  children  and  the  methods  for  overcom- 
ing their  impediment. 

These  classes  for  conservation  of  vision  are  slowly  but  steadily 
becoming  established  in  our  larger  cities.  The  improvement  in 
general  physical  condition  and  scholarship  justifies  the  trouble 
and  additional  expense  incurred  in  conducting  these  special 
classes. 

IDA  E.  RIDGEWAY, 

Supervisor  of  Work  for  Children, 
Massachusetts  Department  of  Education, 
,  Division  of  the  Blind. 


SIGHT-SAVING  CLASSES  IN  THE 
PUBLIC  SCHOOLS 


SIGHT- SAVING  CLASSES  IN  THE 
PUBLIC  SCHOOLS 

SCHOOL  medical  inspection  has  disclosed  the  existence  in  every 
school  population  of  a  certain  proportion  of  pupils  who,  though 
not  blind,  are  seriously  handicapped  in  their  school  work  by  rea- 
son of  marked  defects  of  vision.  These  pupils  can  read  ordinary 
school  books,  but  any  continued  use  of  such  material  is  attended 
by  so  much  strain  of  the  eyes  and  general  nervous  system  as  to 
jeopardize  their  sight  and  general  health.  The  operation  of  our 
compulsory  education  laws  has  brought  these  pupils  forcibly  to 
the  attention  of  school  and  health  authorities. 

Eye  defects  in  such  cases  are  as  follows:  (i)  those  which  cause 
a  considerable  dimness  of  vision,  but  which  are  more  or  less  static 
in  nature,  such  as  scars  or  opaque  spots  on  the  cornea  or  trans- 
parent part  of  the  eye;  (2)  those  which  do  not  cause  a  marked 
reduction  in  visual  power,  but  which  grow  progressively  worse 
under  unfavorable  conditions,  such  as  progressive  myopia,  or 
near-sight,  which  is  likely  to  result  in  the  tearing  away  of  the 
inner  and  most  important  part  of  the  wall  of  the  eye,  the  retina  or 
nerve  layer.  The  proportion  of  pn^ils  having  such  visual  defects 
varies  in  different  places  from  one  "to  every  five  hundred  of  the 
-scfcebl  population  in  the  smaller  cities  to  one  to  one  thousand  of 
the  sefedol  population  in  the  larger  cities.  While  the  number  of 
such  pgpHs  is  small,  it  is  two  or  three  times  as  large  as  is  the 
number  of  blind  children.  Furthermore,  our  neglect  of  this  class 
has  made  it  a  fruitful  field  from  which  to  recruit  the  ranks  of  the 
blind  in  later  life. 

Many  of  these  pupils  have  had  a  hopeless  prospect  in  the  past. 
Some  of  them  who  have  had  the  good  fortune  to  fall  in  with  con- 
siderate teachers  and  who  have  had  wise  parents  have  managed  to 
get  through  school  with  few  ill  effects.  Others  have  worried  along, 
always  at  the  foot  of  the  class,  repeating  every  other  year,  study- 


12  HARVARD  BULLETINS  IN  EDUCATION 

ing  when  their  eyes  would  permit,  bluffing  when  their  eyes  would 
not,  idling  away  their  time,  and  when  their  self-respect  asserted 
itself,  playing  truant.  Some  of  these  pupils  eventually  drop  out  of 
school  either  with  or  without  a  doctor's  certificate.  Other  pupils 
of  this  class  sooner  or  later  find  their  way  into  a  school  for  the 
blind.  In  such  schools  they  are  no  less  misfits  than  they  are  in  the 
regular  classes  in  the  public  schools.  Schools  for  the  blind  accept 
them,  not  because  it  is  felt  that  they  belong  in  such  institutions, 
but  because  there  seems  to  be  no  other  place  to  send  them. 

In  the  school  for  the  blind  the  approach  is  through  the  fingers. 
Every  pupil  must  learn  to  read  by  touch.  At  first,  these  "  seeing  " 
pupils  make  a  serious  effort  to  cooperate  with  the  teachers,  but 
the  process  of  finger  reading  is  so  clumsy,  and  reading  with  the 
eyes  is  so  easy  that  they  soon  supplement  touch  with  sight. 
From  this  time  forward,  it  becomes  a  test  of  persistence  between 
the  teacher  and  the  pupil,  in  which  the  child  generally  wins.  In 
time  the  teacher  comes  to  wink  at  the  practice  of  reading  the 
raised  white  dots  by  sight.  Eventually  many  of  these  pupils 
appear  in  class  with  an  ink  print  book  from  which  they  read 
openly. 

Naturally  schools  for  the  blind  give  little  attention  to  the  proper 
source  and  quantity  of  schoolroom  lighting.  In  one  of  our  best 
residential  schools  for  the  blind  every  classroom  has  a  southern 
exposure.  These  rooms  are  flooded  most  of  the  day  with  bright 
sunshine  which  produces  a  glare  intolerable  to  the  child  with  weak 
eyes.  Other  schools  for  the  blind  have  a  very  inadequate  supply 
of  natural  light,  and  practically  no  artificial  light  is  provided. 
Consequently  many  of  those  who  enter  the  school  for  the  blind 
with  considerable  sight  read  with  their  fingers  cheerfully  before 
they  graduate  as  they  have  no  other  means  of  reading. 

Early  in  the  second  decade  of  the  twentieth  century,  interest 
in  the  problem  of  adapting  public  school  methods  to  the  needs  of 
pupils  with  a  high  degree  of  visual  defect  was  manifested  not 
only  in  several  parts  of  the  United  States,  but  also  in  England  and 
in  Germany.  Although  the  class  opened  in  London  at  the  instiga- 
tion of  M.  Bishop  Harmon  in  1909  was  primarily  for  the  treat- 
ment of  myopic  patients,  an  increasing  percentage  of  pupils  with 


READING  BRAILLE  WITH  WEAK  EYES  CAUSES  DANGEROUS  EYE-STRAIN 


\ 


14  HARVARD  BULLETINS  IN  EDUCATION 

other  visual  defects  has  been  admitted  in  order  to  aid  them  in 
their  school  work. 

In  1911  pupils  having  considerable  vision  who  had  been  as- 
signed to  classes  for  the  blind  in  Cleveland  were  permitted  to 
make  a  moderate  use  of  the  blackboard  and  of  school  text-books 
under  the  direct  supervision  of  the  school  oculist. 

In  the  spring  of  1913,  the  city  of  Boston  opened  a  class  for  so- 
called  "semi-seeing"  children.  This  step  was  taken  at  the  urgent 
request  of  the  Perkins  Institution  for  the  Blind  which  continued 
for  years  to  extend  to  these  classes  and  other  similar  classes  in 
Massachusetts  much  financial  and  moral  support. 

In  the  fall  of  1913,  the  city  of  Cleveland  removed  from  its' 
classes  for  the  blind  all  pupils  who  had  been  taught  through  their 
eyes  rather  than  through  their  fingers,  and  organized  them  into 
special  classes  known  as  conservation  of  vision  or  sight-saving 
classes.  A  little  later  Cincinnati,  Toledo,  and  several  other  Ohio 
cities  opened  up  similar  classes.  During  the  same  period  several 
Massachusetts  cities  followed  the  lead  of  Boston  and  made 
similar  provision  for  their  pupils  with  defective  vision.  New 
York  City  opened  a  few  of  these  classes  as  an  experiment,  and 
soon  became  so  flooded  with  applicants  that  those  in  charge  of 
the  department  almost  despair  of  meeting  the  demand.  Re- 
cently Detroit,  Grand  Rapids,  Minneapolis,  Duluth,  Rochester, 
Buffalo,  Philadelphia,  Halifax,  Nova  Scotia,  and  other  cities  have 
organized  conservation-of-vision  classes.  Milwaukee  has  adopted 
the  special  method  of  instruction  used  in  sight-saving  classes,  but 
as  yet  has  not  separated  the  partially  sighted  from  those  who  are 
blind. 

Few  innovations  in  educational  methods  have  met  with  so  much 
universal  approval  as  has  the  separation  for  instruction  purposes 
of  blind  and  partially  blind  pupils.  Schools  for  the  blind,  state 
commissions  for  the  blind,  city  societies  for  the  blind,  and  the 
National  Committee  for  the  Prevention  of  Blindness  have  pro- 
moted this  movement  with  energy  and  enthusiasm.  Illinois, 
Massachusetts,  Minnesota,  New  York,  Ohio,  Pennsylvania,  and 
Wisconsin  have  enacted  state  laws  providing  financial  assistance 
to  cities  conducting  such  classes. 


UNRESTRICTED  READING  IN  THIS  WAY  is  NOT  ONLY  PAINFUL  BUT 

DANGEROUS 


1 6  HARVARD  BULLETINS  IN  EDUCATION 

Sight-saving  class  departments  have  three  fairly  definite  aims: 
first,  to  instruct  the  pupils  with  a  minimum  of  eye-strain;  sec- 
ond, to  teach  them  how  to  conserve  the  vision  they  possess;  and, 
third,  to  provide  such  vocational  guidance,  and,  if  necessary,  vo- 
cational training  as  will  enable  them  to  fill  the  most  useful  places 
in  the  community  their  powers  will  permit. 

The  most  common  method  of  procedure  in  establishing  a  sight- 
saving  class  is  to  designate  a  public  school  building  as  a  conserva- 
tion-of-vision  school.  To  this  building  are  assigned  eight  or  ten 
children  seriously  handicapped  in  regular  school  work  by  reason 
of  defective  vision.  They  possess  sufficient  sight,  however,  to 
enable  them  to  make  some  use  of  ordinary  book  print.  In  de- 
veloping this  work,  care  is  usually  taken  not  to  set  these  children 
apart  from  others  any  more  than  is  necessary.  The  regular  or- 
ganization of  the  school  is  disturbed  as  little  as  possible,  and  not 
more  than  twelve  pupils  are  assigned  to  any  one  building. 

In  buildings  designated  as  conservation-of-vision  schools,  a 
room  is  set  aside  for  the  use  of  children  with  defective  eyesight. 
A  teacher  is  placed  in  charge  of  the  room  whose  function  it  is  to 
assist  these  children  to  keep  pace  with  the  boys  and  girls  enjoy- 
ing normal  eyesight.  All  written  work  is  done  in  the  special 
room.  Practically  all  oral  work  is  performed  in  the  regular  grade 
room  with  the  other  children.  For  example,  a  fifth  grade  child 
does  his  written  arithmetic,  map  work,  reading,  written  composi- 
tion, and  writing  with  the  special  teacher.  Oral  arithmetic, 
geography,  history,  grammar,  oral  spelling,  etc.,  are  recited  in  the 
regular  fifth  grade  room.  This  keeps  the  sight-saving  class  pupil 
in  competition  with  those  enjoying  normal  vision,  and  guards 
against  the  tendency  to  set  special  standards  applicable  only  to 
special  groups. 

Pupils  of  such  classes,  upon  leaving  school,  regard  themselves 
not  as  graduates  of  the  special  class,  but  of  the  school  in  which  the 
class  is  located.  Such  pupils  meet  the  world  with  a  confidence 
which  a  training  in  competition  exclusively  with  handicapped 
classmates  could  not  possibly  inspire.  Furthermore,  the  em- 
ployer accepts  without  question  the  graduate  of  a  regular  public 
school  whose  standards  are  familiar  to  him,  while  the  graduate 


O 
o 

M 

S 


1 8  HARVARD  BULLETINS  IN  EDUCATION 

of  a  special  class  must  assume  the  burden  of  proof,  often  in  the 
face  of  actual  prejudice. 

The  plan  of  coeducation  of  conservation- of- vision  pupils  with 
pupils  having  normal  sight  offers  many  complications,  and  re- 
. quires  the  careful  supervision  of  a  school  authority  who  will  keep 
constantly  before  all  concerned  the  fundamental  principle  that 
school  methods  should  be  so  planned  as  best  to  train  the  pupil  for 
the  broader  field  of  life. 

The  building  selected  for  conservation-of- vision  work  should  of 
course  have  good  lighting  conditions.  The  special  room  should  be 
a  model  so  far  as  eye-hygiene  is  concerned.  The  window-glass 
area  should  equal  not  less  than  one-fifth  the  floor  area.  In  case 
of  bilateral  lighting,  the  walls  containing  windows  should  be  adja- 
cent. The  light  coming  from  the  rear  in  such  rooms  should  be  of 
less  intensity  than  that  coming  from  the  left;  otherwise  trouble- 
some body  shadows  upon  the  desks  may  result.  The  more  desir- 
able directions  of  the  source  of  light  are,  in  order  of  preference, 
northeast,  east,  north  and  east,  northwest,  north  and  west.  A 
southern  exposure  should  be  avoided  because  of  the  glare  and 
fluctuation  in  the  intensity  of  light  in  south  rooms. 

Windows  should  be  provided  with  adjustable  window  shades 
which  enable  the  teacher  to  exclude  direct  rays  of  the  sun  without 
darkening  the  entire  window.  When  adjustable  window  shades 
are  not  used,  the  windows  should  be  equipped  with  two  shades, 
one  at  the  top  and  one  either  at  the  bottom  or  at  the  top  of  the 
lower  sash. 

An  adequate  scientifically  planned  artificial  lighting  system  is 
essential  for  use  on  cloudy  days.  Semi-indirect  lighting  usually 
gives  the  best  results.  The  best  lighted  sight-saving  classrooms 
are  provided  with  from  two  and  one  half  to  three  watts  of  electric 
light  power  per  square  foot  of  floor  area. 

Glare  should  be  reduced  to  a  minimum  by  refinishing  the  desks 
and  all  other  woodwork  with  a  mat  surface.  The  walls  should 
be  decorated  with  a  good  neutral  tint,  preferably  French  gray, 
and  should  be  done  with  calcimine  or  some  other  coating  produc- 
ing a  dull  finish.  Adjacent  buildings  should  be  sufficiently  distant 
to  permit  a  good  sky  line.  Five  vertical  degrees  of  sky  should  be 


20  HARVARD  BULLETINS  IN  EDUCATION 

visible  from  every  part  of  the  room  in  which  the  children  are 
required  to  work. 

The  blackboard  is  the  most  essential  part  of  the  equipment  of 
such  rooms.  The  room  should  be  fitted  with  good  slate  boards 
and  a  plentiful  supply  of  blackboard  cloth  and  desk  writing- 
boards. 

The  teacher  of  such  a  class  should  be  under  the  constant  advice 
of  an  eye  specialist  with  whom  she  can  counsel  frequently  regard- 
ing the  ocular  condition  of  each  pupil.  The  amount  of  close  work 
which  any  child  may  safely  perform  depends  entirely  upon  the 
peculiar  condition  of  his  eyes.  If  any  use  at  all  is  made  of  ordi- 
nary book  print  it  should  be  upon  the  advice  of  the  attending 
ophthalmologist.  Most 'textbooks  used  in  the  conservation-of- 
vision  classes  are  printed  in  a  twenty-four  point  heavy  type.  An 
unglazed  book  stock  paper,  with  a  slightly  buff  tint,  is  employed.1. 

Written  work  in  these  classes  is  done  largely  upon  the  black- 
board. Certain  pupils,  however,  are  permitted  to  use  a  soft  heavy 
pencil  such  as  is  commonly  found  in  the  first  grade  classrooms. 
The  pencil  work  is  done  upon  an  unglazed  manila  paper,  ruled  at 
intervals  of  about  an  inch.  The  accompanying  illustration  shows 
a  pupil  working  arithmetic  problems  upon  such  paper.  He  has 
drawn  his  movable  desk  up  to  the  blackboard  where  he  can  see 
the  problems  which  the  teacher  has  placed  on  the  board,  and 
where  he  has  very  satisfactory  light. 

Pupils  above  the  fourth  grade  are  taught  to  write  on  the  type- 
writer, using  the  touch  method.  This  enables  them  to  do  much  of 
their  written  work  without  any  eye  strain  whatever.  In  the  ac- 
companying illustration  the  copy-holder  containing  the  lesson  for 

1  As  sight-saving  classes  are  still  not  very  numerous,  the  demand  for  textbooks  in 
large  type  is  too  small  to  make  their  production  financially  attractive  to  any  com- 
mercial book-publishing  concern.  The  need  for  such  texts  has  been  partially  met  by 
the  Howe  Publishing  Society  for  the  Blind,  Old  Court  House,  Cleveland,  Ohio, 
which  is  a  philanthropic  organization  interested  primarily  in  printing  books  for  the 
blind.  This  society  has  annually  received  orders  from  most  of  the  cities  conducting 
conservation-of-vision  classes.  By  pooling  this  business  it  has  been  able  to  negotiate 
contracts  with  job  printers  and  book  binders  for  the  publication  at  one  time  of  the 
entire  year's  demand  of  the  country.  While  the  books  which  are  sold  by  this  or- 
ganization at  cost  are  still  quite  expensive,  the  cost  of  production  is  far  lower  than 
would  be  possible  were  each  city  to  do  its  printing  independently. 


SIGHT-SAVING  CLASS  PUPIL  PRACTISING  TYPEWRITING 


22  HARVARD  BULLETINS  IN  EDUCATION 

the  day  rests  upon  the  floor  and  is  independent  of  the  typewriter 
stand.  This  eliminates  the  troublesome  vibration  inevitable  when 
the  copy-holder  is  attached  either  to  the  typewriter  or  to  the 
table  upon  which  the  typewriter  rests. 

The  ordinary  maps,  such  as  are  found  in  the  geography  text- 
books, and  even  wall  maps  contain  so  much  detail  and  so  much 
fine  print  that  it  is  not  safe  to  permit  the  sight-saving  class  pupil 
to  make  use  of  them.  The  outline  maps  which  consist  of  lines 
drawn  with  paint  upon  slated  cloth,  showing  the  general  political 
divisions,  together  with  the  rivers,  coast  lines,  and  other  main 
physical  features,  are  coming  into  general  use  in  conservation-of- 
vision  classes.  On  these  maps  it  is  possible  to  insert  at  will  all 
necessary  detail  as  needed.  Such  insertions  may  be  erased  and 
others  made  so  that  at  all  times  the  particular  subject  matter 
under  consideration  stands  out  clearly. 

Much  emphasis  is  placed  upon  hand  training  in  the  sight-saving 
classes.  These  pupils  are  taught  to  use  their  hands  without  look- 
ing closely  at  what  they  are  doing.  It  is  hoped  in  this  way  to 
relieve  them  of  much  habitual  eye-strain  in  their  everyday  occu- 
pations. 

The  object  of  the  sight-saving  class  would  be  but  half  attained 
were  the  teacher  satisfied  with  enabling  her  pupils  to  do  their 
school  work  with  as  little  eye-strain  as  possible,  and  giving  them 
thorough  instruction  in  eye  hygiene.  The  conservation  of  one's 
limited  vision  is  not  so  much  a  matter  of  information  as  it  is  that 
of  habit  of  life.  This  requires  not  only  patient  and  persistent  ex- 
planation and  reiteration  to  the  child,  but  also  necessitates  fre- 
quent visits  to  his  home.  It  does  little  good  for  the  teacher  to 
copy  the  pupil's  arithmetic  in  large  script  and  to  shield  him  from 
the  evil  effects  of  glare  during  the  day,  if  by  night  he  is  permitted 
to  attend  the  "movies"  or  to  read  the  ordinary  library  books  by 
the  poor  light  usually  available.  A  confidential  and  sympathetic 
relationship  with  the  parents  must  be  established  and  their  intel- 
ligent cooperation  enlisted.  Then  does  the  child's  instruction  in 
conservation-of- vision  continue  throughout  all  his  waking  hours. 

In  order  to  measure  the  results  of  sight-saving  class  work  two 
criteria  may  be  used:  (i)  To  what  extent  have  these  classes 


24  HARVARD  BULLETINS  IN  EDUCATION 

actually  conserved  vision?  (2)  How  does  the  scholarship  of  the 
pupils  in  the  sight-saving  classes  compare  with  their  scholarship 
prior  to  assignment  to  such  classes  ?  No  extensive  statistical 
study  has  yet  been  made  of  the  effect  of  sight-saving  class  work 
upon  the  eyes  of  the  pupils.  A  study  of  a  small  group  by  Dr. 
Louis  Strieker  of  Cincinnati,  has  indicated  most  gratifying  results. 
From  general  observation  it  seems  clear  that  by  relieving  these 
pupils  of  eye-strain  during  the  period  of  their  school  course, 
deterioration  has  been  almost  universally  checked.  Eye  special- 
ists agree,  however,  that  in  most  of  the  cases  assigned  to  con- 
servation-of-vision  classes,  little  improvement  in  eye  condition 
should  be  looked  for.  The  most  that  we  may  hope  is  that  these 
pupils  will  get  through  school  with  little  or  no  reduction  of  vision. 
Persons  thoroughly  trained  throughout  their  school  life  in  the 
care  of  their  eyes  may  be  expected  to  conserve  their  vision  after 
reaching  mature  years. 

A  study  of  the  promotion  records  of  100  sight-saving  class 
pupils  in  Cleveland  shows  a  reduction  of  85  per  cent  in  the  pro- 
portion of  failures  after  the  work  in  the  sight-saving  classes  is 
well  begun,  as  compared  with  the  proportion  of  failures  of  these 
pupils  prior  to  entrance  in  the  sight-saving  classes.  The  propor- 
tion of  failures  among  the  sight-saving  class  pupils  is  60  per  cent 
less  than  the  proportion  of  failures  in  the  entire  public  school 
system. 

Having  brought  these  children  through  school  with  little  or  no 
diminution  of  vision,  and  having  taught  them  to  conserve  their 
limited  sight,  the  responsibility  still  rests  upon  the  school  to  place 
them  in  occupations  where  they  can  attain  a  maximum  of  effi- 
ciency with  a  minimum  of  eye-strain.  In  most  places,  sight-sav- 
ing class  pupils  receive  more  or  less  aid  in  securing  suitable  em- 
ployment after  leaving  school.  Cleveland  added  to  its  sight- 
saving  class  department  a  few  years  ago  a  vocational  guidance 
worker.  Her  duties  are  briefly :  to  study  the  older  boys  and  girls 
with  a  view  to  determining  their  vocational  interests  and  pos- 
sibilities, and  their  social  traits  and  characteristics;  to  suggest 
courses  of  study,  and  to  visit  the  high  school  pupils  in  their  class- 
rooms, conferring  with  their  teachers  in  regard  to  their  work  and 


26  HARVARD  BULLETINS  IN  EDUCATION 

tendencies;  to  become  acquainted  with  the  families  of  these 
children,  and  to  take  an  active  interest  in  their  social  life.  All  this 
is  done  with  a  view  to  learning  just  how  the  individual  can  be- 
come an  efficient,  self-supporting,  respected  member  of  his  own 
community.  Furthermore,  the  vocational  guidance  worker  finds 
"odd  jobs"  for  the  boys  and  girls  who  must  work  while  attending 
schools.  She  calls  upon  business  and  professional  men  and 
women,  and  welfare  supervisors  in  stores  and  factories,  in  an 
effort  to  interest  them  in  her  charges  as  wage  earners.  The  aim  is 
not  merely  to  find  simple  processes  which  persons  with  defective 
vision  can  perform,  but  to  discover  lines  of  occupation  in  which 
they  can  safely  engage  with  a  limited  degree  of  vision.  Such  oc- 
cupation should  offer  opportunities  for  advancement  without 
injury  to  their  eyes,  general  health,  or  morals.  The  vocational 
guidance  worker's  task  does  not  end  until  each  pupil  is  placed 
in  the  position  for  which  he  is  best  fitted  by  training  and  natural 
inclination,  and  is  thus  given  a  chance  to  prove  himself  socially 
and  industrially  a  successful  member  of  the  community.  When 
such  persons  are  satisfactorily  placed,  the  public  school  sight- 
saving  class  department  has  fulfilled  its  obligations.  Thenceforth 
it  is  the  duty  of  a  publicly  supported  employment  bureau  to 
undertake  this  responsibility. 

The  spread  of  the  sight-saving  classes  to  the  smaller  cities  has 
given  an  opportunity  to  compare  the  prevalence  of  defective  eye- 
sight in  large  and  small  places.  In  Cleveland  there  has  been  found 
one  conservation-of- vision  pupil  to  every  thousand  of  the  school 
population.  The  same  ratio  would  seem  to  hold  in  Cincinnati. 
In  Mansfield,  Ashtabula,  and  Alliance,  the  ratio  is  about  one  to 
every  five  hundred  of  the  school  population.  It  is  probable  that 
this  is  a  result  of  the  special  attention  given  to  eyes  by  the  medical 
inspection  departments  of  our  large  cities. 

Considering  for  a  moment  the  future  development  of  this  form 
of  special  school  activity  it  would  seem  that  the  sight-saving  class 
movement  has  just  begun.  The  surprising  proportion  of  children 
with  defective  eyesight  in  the  smaller  cities  would  indicate  that 
every  city  having  a  population  of  20,000  or  more  is  in  need  of  a 
class  of  this  kind. 


SIGHT-SAVING  CLASSES  IN  THE  PUBLIC  SCHOOLS         27 

Several  attempts  have  been  made  by  eye  specialists  to  state  in 
general  terms  the  kinds  and  degrees  of  visual  defect  which  indi- 
cate the  need  of  some  special  school  accommodation.  Though  the 
technical  terms  employed  render  these  descriptions  almost  unin- 
telligible to  the  layman,  two  of  these  statements  are  appended  as 
they  will  be  of  some  assistance  to  eye  specialists  in  determining 
which  of  their  patients  should  be  referred  to  sight-saving  classes. 

Each  individual  applicant  must,  however,  for  the  present  be 
considered  separately.  As  yet  we  can  be  certain  only  thus  far : 
any  child  who  has  a  defect  of  vision  which  makes  it  impossible,  or 
inadvisable,  for  him  to  be  instructed  in  the  ordinary  way  should 
have  some  special  school  provision  for  his  case.  Any  community 
which  fails  to  do  this  must  pay  the  price  in  dollars  and  cents  for 
the  loss  of  economic  efficiency  of  certain  of  its  citizens. 


28  HARVARD  BULLETINS  IN  EDUCATION 


APPENDIX  A 

DESCRIPTION  or  ELIGIBLE  CANDIDATES  TO  SIGHT-SAVING  CLASSES 

PREPARED  BY  A  COMMITTEE  or  CINCINNATI  EYE  SPECIALISTS,  OF 

WHICH  DR.  Louis  STRICKER  WAS  CHAIRMAN 

1.  Children  who  cannot  read  more  than  6/21  at  distance  and  who 
cannot  read  2.00  at  20  c.m. 

2.  Myopes  who  have  more  than  five  diopters  of  myopia. 

3.  Hyperopes  who  have  symptoms  of  asthenopia  and  who  have  more 
than  five  diopters  of  hyperopia. 

4.  Children  who  have  an  astigmatism  of  more  than  3.5  diopters  and 
whose  vision  cannot  be  brought  up  to  more  than  6/24. 

5.  Children  with  maculae,  nebulae,  leucomae,  which  interfere  with 
sight  and  lead  to  eye-strain. 

NOTE.  It  is  assumed  that  these  conditions  exist  after  the  proper  refractions  have 
been  made. 

DESCRIPTION  or  CASES  INDICATING  SIGHT-SAVING  CLASS  TREATMENT 

PREPARED  BY  DR.  DOUGLAS  F.  WOOD,  or  MINNEAPOLIS,  AFTER  SOME 

STUDY  OF  THIS  SUBJECT 

1.  Myopes  of  8  diopters  or  more. 

2.  Myopes  whose  vision  cannot  be  brought  up  to  one-half  normal 
vision:  6/12. 

3.  Progressive  myopia. 

4.  Children  having  macula  or  leucoma  of  the  cornea;    or  optic 
atrophy  with  vision  less  than  6/15. 

5.  Astigmatism  with  glasses  6/21  or  less. 

6.  Hyperopia  with  more  than  eight  diopters,  with  symptoms  of 
asthenopia. 

7.  Keratitis.   In  the  interstitial  type,  if  the  vision  remains  low  after 
the  eye  has  been  quiet  for  three  months,  or  in  persistent  recurrent 
conditions  while  under  treatment. 

8.  In  congenital  cataracts,  or  secondary  cataracts  where  no  acute 
condition  is  present,  vision  6/15  or  less. 

9.  Congenital  malformations,  where  the  vision  is  6/21  or  less. 

10.    In  all  chronic  diseases  of  the  fundus,  where  the  vision  is  6/12  or 
less. 


SIGHT-SAVING  CLASSES  IN  THE  PUBLIC  SCHOOLS         29 


APPENDIX  B 

A  classification  of  .the  eye  conditions  of  181  Ohio  pupils  whose  eye 
histories  are  available  is  arranged  in,  the  accompanying  table.  This 
distribution  of  cases  will  be  of  interest  to  any  oculist  investigating  the 
subject  of  sight-saving  classes,  as  it  shows  the  actual  proportion  of 
various  kinds  of  eye  defects  prevalent  among  the  pupils  now  attending 
schools  in  the  cities  from  which  this  material  has  been  selected.  The 
percentage  of  myopic  cases  is  lower  than  we  should  expect  to  discover. 
It  is  probable  that  this  fact  is  attributable  to  an  undue  conservatism 
among  eye  specialists  in  assigning  to  sight-saving  classes  extremely 
near-sighted  pupils  whose  degree  of  vision  can  be  brought  up  to  near 
normal  with  glasses.  The  reluctance  of  oculists  to  assign  such  cases  to 
sight-saving  classes  grows  out  of  the  difficulty  of  convincing  the  parents 
of  the  need  of  relieving  the  child  of  all  eye-strain,  in  spite  of  the  fact 
that  with  glasses  he  seems  to  see  well  and  suffers  no  pain.  Sight-saving 
classes  would  be  able  much  more  thoroughly  to  fulfil  their  function  in 
the  community  if  eye  specialists  would  assign  to  these  classes  all  cases 
of  short-sight  which  they  may  be  reasonably  confident  will  become 
progressively  worse  when  subjected  to  the  strain  which  regular  school 
work  entails. 


30  HARVARD  BULLETINS  IN  EDUCATION 

CLASSIFICATION  OF  DIAGNOSES  OF  EYE  CONDITIONS  OF  181  SIGHT-SAVING 
CLASS  PUPILS  IN  OHIO 

Eye  Diagnoses  Number  of  Pupils    Per  cent 

Albino 3  1.6 

Astigmatism 48  26.5 

Hyperopic  Astigmatism 28 

Myopic  Astigmatism 10 

Mixed  Astigmatism 10 

48 

Buphthalmos  (protrusion  of  the  cornea) i  .5 

Cataracts  (an  opaque  formation  in  the  crystalline  lens) ...                 20  1 1  .o 
Choroiditis  (inflammation  of  the  choroid,  or  coat  of  the 

eye  containing  most  of  the  blood  vessels) 9  4.9 

Congenital    Malformation    (imperfect    development    of 

retina) i  .5 

Corneal  Scars 21  n.6 

Ectopialentis  (dislocation  of  the  crystalline  lens) 3  1.6 

Glaucoma i  .5 

Hyperopia  (far-sight) 5  2.7 

Interstitial  Keratitis  (an  inflammation  of  the  cornea) 12  6.6 

Myopia  (near-sight) 28  15.4 

Nystagmus  (a  condition  in  which  the  eye  is  continually 

moving) 19  10.5 

Optic  Atrophy  (paralysis  of  the  optic  nerve) 6  3.3 

Retinitis  (inflammation  of  the  retina) ..: 4  2.2 

Retinitis  pigmentosa 2 

Choroid  retinitis 2 

4 

DISTRIBUTION  OF  DEGREE  OF  VISION  POSSESSED  BY  181  SIGHT-SAVING 
CLASS  PUPILS  IN  OHIO 

Degree  of  Vision                                                Number  of  Pupils  Per  cent 

5/6o 6  3.3 

6/60 ..          32  17.6 

6/9 4  (myopes)  2.2 

6/21 25  13.8 

6/15 17  9-4 

6/12 7  (myopes)  3.8 

6/30 25  13.8 

6/24 24  13.2 

6/18 , 14  7-7 

6/36 26  14.3 

4/60 i  .5 

NOTE.  In  determining  the  degree  of  vision  the  test  card  is  usually  placed  at 
6  meters  (20  feet)  from  the  patient,  and  he  is  asked  to  read  all  of  the  lines  on  the 
card  visible  to  him  at  that  distance.  The  top  line  should  be  visible  to  a  patient 


SIGHT-SAVING  CLASSES  IN  THE  PUBLIC  SCHOOLS       31 

having  normal  sight  at  a  distance  of  60  meters  (about  200  feet);  the  second  line 
should  be  visible  at  30  meters  (about  100  feet) ;  the  fifth  line  should  be  visible  at 
1 2  meters  (about  40  feet) ;  the  sixth  line  should  be  visible  at  6  meters  (about  20 
feet) .  The  degree  of  vision  of  a  patient  who  can  read  the  top  line  only  is  expressed 
as  6/60  vision,  signifying  that  he  can  read  at  6  meters  what  he  should  be  able  to 
read  at  60  meters.  The  degree  of  vision  of  a  patient  reading  only  the  first  five  lines 
is  expressed  as  6/12  vision,  meaning  that  he  can  read  at  6  meters  what  he  should  be 
able  to  read  at  12  meters.  A  person  having  normal  vision  can  read  the  sixth  line  at 
6  meters.  His  degree  of  vision  is  expressed  as  6/6.  Patients  who  cannot  read  the 
top  line  at  6  meters  are  frequently  allowed  to  approach  the  card  until  this  line  be- 
comes legible;  for  example,  a  person  who  must  approach  to  within  5  meters  of  the 
test  card  is  said  to  have  5/60  vision,  those  who  must  approach  to  within  4  meters 
are  said  to  have  4/60  vision. 

APPENDIX  C 

BIBLIOGRAPHY 

Report  of  Minnesota  School  for  the  Blind,  1910,  p.  33. 

Report  of  Boston  School  Committee,  1913,  p.  54;   1914,  p.  32. 

Report  of  the  Superintendent  of  Schools  of  Cleveland,  1913-14,  p.  42. 

Report  of  Pennsylvania  Institution  for  the  Blind,  1914,  p.  34;   1916,  p.  109. 

Report  of  Massachusetts  Commission  for  the  Blind,  1914,  p.  70;  1916, 
pp.  16-49;  1916,  p.  63. 

Report  of  United  States  Commissioner  of  Education,  1915,  vol.  i,  p.  507. 

Report  of  Cincinnati  Board  of  Education,  1916,  p.  255. 

Report  of  Superintendent  of  Schools  of  Boston,  1917,  p.  90. 

Cincinnati  Board  of  Health  Bulletin,  September  18,  1915. 

Monthly  Bulletin  of  Department  of  Health,  City  of  New  York,  vol.  ix, 
September,  1919,  p.  220. 

Archives  of  Ophthalmology,  vol.  xliv,  1913,  p.  186. 

Ohio  State  Medical  Journal,  vol.  xiii,  1917,  p.  813;  vol.  xiv,  1918,  p.  81. 

American  Journal  of  Public  Health,  vol.  vii,  1917,  p.  782. 

Cleveland  Medical  Journal,  vol.  xvii,  1918,  p.  245. 

Modern  Medicine,  July,  1918,  vol.  i,  No.  3,  pp.  257-264. 

W.  C.  Posey,  "Hygiene  of  the  Eye,"  1918,  p.  95. 

Proceedings  of  the  American  Association  of  Instructors  of  the  Blind,  1916, 
pp.  12-88^1918,  pp.  58,  59,  60. 

Boston  Transcript,  May  20,  1916. 

Ohio  Teacher,  vol.  xxxviii,  1916,  p.  32. 

Outlook  for  the  Blind,  vol.  x,  1916,  p.  9;  vol.  xii,  1918,  pp.  67-71. 

Cleveland  Society  for  the  Blind,  "The  Blind  in  Cleveland,"  1918,  p.  42. 

Louis  Strieker,  "Blindness  in  Hamilton  County,"  1918,  pp.  66-91. 

Publication  of  the  National  Committee  for  the  Prevention  of  Blindness,  No. 
18,  "Manual  for  Conservation  of  Vision  Classes,"  by  Winifred  Hatha- 
way, November,  1919. 

Attention  is  especially  called  to  the  "Manual  for  Conservation  of  Vision 
Classes,"  which  should  be  in  the  hands  of  every  sight-saving  class  teacher. 


PRINTED  AT 

THE  HARVARD  UNIVERSITY  PRESS 
CAMBRIDGE,  MASS.,  U.S.A. 


LD 


UNIVERSITY  OF  CALIFORNIA  LIBRARY 


